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Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD

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Abstract

This review discusses the usefulness of bedside lung ultrasound in the diagnostic distinction between different causes of acute dyspnea in the emergency setting, particularly focusing on differential diagnosis of pulmonary edema and exacerbation of chronic obstructive pulmonary disease (COPD). This is possible using a simple unit and easy-to-acquire technique performed by radiologists and clinicians. Major advantages include bedside availability, absence of radiation, high feasibility and reproducibility, and cost efficiency. The technique is based on analysis of sonographic artifacts instead of direct visualization of pulmonary structures. Artifacts are because of interactions between water-rich structures and air and are called “comet tails” or B lines. When such artifacts are widely detected on anterolateral transthoracic lung scans, we diagnose diffuse alveolar-interstitial syndrome, which is often a sign of acute pulmonary edema. This condition rules out exacerbation of COPD as the main cause of an acute dyspnea.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Torino, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy

    Giovanni Volpicelli

  2. Institute of Radiology, University of Torino, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy

    Luciano Cardinale, Giorgio Garofalo & Andrea Veltri

  3. Medicina d’Urgenza, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy

    Giovanni Volpicelli

Authors
  1. Giovanni Volpicelli
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  2. Luciano Cardinale
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  3. Giorgio Garofalo
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  4. Andrea Veltri
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Correspondence to Giovanni Volpicelli.

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The author did not receive personal or financial support from or has any affiliations or involvement with any organization with financial interest in the subject matter.

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Volpicelli, G., Cardinale, L., Garofalo, G. et al. Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD. Emerg Radiol 15, 145–151 (2008). https://doi.org/10.1007/s10140-008-0701-x

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  • DOI: https://doi.org/10.1007/s10140-008-0701-x

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